The superficial radial artery-a cautionary tale of two pedicles.

The radial forearm free flap is a common reconstructive option following ablative head and neck surgery. Although uncommon, anatomical variants such as radial artery anomalies pose risks to flap harvest and viability. A rare case of a common radial artery that branched distally into a superficial radial artery and a deep radial artery is reported here.

Immediate prosthetic nasal rehabilitation following rhinectomy: indications and limitations of the epiplating system - a case series.

Nasal reconstruction post-rhinectomy is challenging. Nasal prostheses using the Medicon epiplating system (Medicon) provides a simpler alternative with good patient outcomes. Eight patients (mean age 65 years; equal gender distribution) underwent immediate nasal rehabilitation using a unilateral nasal Epiplate implant for magnet-retained prostheses post-rhinectomy, with follow-up from five to 37 months (mean 13 months).

Surface ECG criteria can discriminate post-septal pacing cardiac memory from ischemic T wave inversions.

Unlabelled: Cardiac memory (CM) refers to transient T wave changes that appear after cessation of a period of abnormal ventricular activation, such as right ventricular (RV) pacing. ECG criteria for differentiating post-pacing CM from ischemia-induced T wave changes were previously published only for apical, but not for septal RV pacing.

Aim: To find ECG criteria for discriminating post-septal pacing CM from ischemic T wave inversions.

Reproducibility of Combined Acquisition and Measurement of Left Ventricular Longitudinal Peak Segmental Strain in Relation to the Severity of Left Ventricular Dysfunction.

Background: Whether left ventricular (LV) longitudinal peak systolic segmental strain (LPSS) has sufficient reproducibility to be used in clinical practice (e.g., in patient follow-up) remains unclear.

A Review of Driving Restrictions in Patients at Risk of Syncope and Cardiac Arrhythmias Associated with Sudden Incapacity: Differing Global Approaches to Regulation and Risk.

The ability to drive is a highly valued freedom in the developed world. Sudden incapacitation while driving can result in injury or death for the driver and passengers or bystanders. Cardiovascular conditions are a primary cause for sudden incapacitation and regulations have long existed to restrict driving for patients with cardiac conditions at high risk of sudden incapacitation.

Spontaneous closure of an acquired ventricular septal defect.

Ventricular septal defect (VSD) is a rare but serious complication of acute myocardial infarction requiring early surgical intervention. A patient with acquired VSD that spontaneously closed over three months is presented. The literature on spontaneous closure of acquired VSDs is also reviewed.

Localized pneumocephalus caused by Clostridium perfringens meningitis.

Clostridium meningitis is a rare complication of elective surgery, but the presence of pneumocephalus on CT in the absence of penetrating injuries, should raise the possibility of anaerobic infections. We report a case of fatal Clostridium perfringens meningitis which occurred 4 months after a craniotomy for glioblastoma multiforme. The diagnosis was suspected based on the CT findings.

Renal malacoplakia: an important consideration in the differential diagnosis of renal masses in the presence of Escherichia coli infection.

Renal malacoplakia is an uncommon condition with a variety of radiological characteristics which may initially suggest an alternative diagnosis. Three cases of renal malacoplakia were diagnosed in our hospital during a 2 year period. This apparent cluster of cases probably reflects the increased use of imaging and biopsy in the investigation of elderly hospitalized patients.

Spontaneous haemothorax: a cause of sudden death in von Recklinghausen's disease.

Vasculopathy is a relatively frequent but poorly recognised manifestation of von Recklinghausen's neurofibromatosis. One of its more dramatic presentations is as spontaneous haemothorax. Clinicians and pathologists should be aware of this syndrome as a cause of sudden death in patients with neurofibromatosis.

Maxillofacial prosthodontics and reconstruction: a Canadian view.

A craniofacial osseointegration and maxillofacial prosthetic rehabilitation unit in Edmonton, Canada was visited by the author as part of a higher specialist training programme. The unit has an international reputation as a centre of excellence for the treatment of patients with head and neck abnormalities. The report examines the activities of the unit and how it achieves its 'patient centred' approach to care.

Gastrointestinal tumour masses due to multiple myeloma: a pathological mimic of malignant lymphoma.

Aims: To describe and evaluate two cases of gastrointestinal involvement by multiple myeloma.

Methods And Results: Clinical details were obtained from patients records and routine histopathological sections were correlated with haematological and immunohistochemical investigations. As shown in the accompanying illustrations, myeloma manifests as large, atypical, non-cohesive cells which may mimic high-grade lymphoma.

Implant rehabilitation of irradiated jaws: a preliminary report.

Ten patients (3 maxilla, 7 mandible), who had been treated for a head and neck malignancy by undergoing radiotherapy, had 42 implants (10 maxillary, 32 mandibular) placed into the irradiated sites and either an overdenture or a fixed prosthesis fabricated. Of the 10 implants placed in the maxilla, 6 were lost; however, there was a 100% survival rate of the implants placed in the mandible (mean duration = 33 months). The use of longer implants and pre- or postimplant hyperbaric oxygen may be necessary in maxillary situations.

Maxillectomy--to reconstruct or obturate? Results of a UK survey of oral and maxillofacial surgeons.

Post-maxillectomy defects may be restored either by surgical reconstruction or by prostheses and there is continuing controversy about the most appropriate method of rehabilitation in any particular case. A questionnaire was designed to assess the current practices of oral and maxillofacial surgeons in the UK after resection of the maxilla for malignant disease. Maxillectomies were carried out by 83% of surgeons; most surgeons do 1-5 cases a year; 38% of surgeons do reconstruct surgically, but only in 10% of cases.